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General NPI Number Information
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NPI Number | 1639330152
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Entity Type | Organization
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Legal Business Name | RENA AHUJA MD, INC.
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 17150 EUCLID ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4092
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Country | US
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Telephone | 312-593-8177
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2724
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City | NEWPORT BEACH
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State | CA
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Zip | 92659-0210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RENA AHUJA
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Credential | M.D.
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Telephone | 312-593-8177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A90836
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License Number State | CA
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